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Levofloxacin and ciprofloxacin decrease procainamide and N-acetylprocainamide renal clearances.

Larry A Bauer1, Douglas J Black, Jennifer S Lill

  • 1Department of Pharmacy, Box 357630, University of Washington, Seattle, WA 98195. labauer@u.washington.edu.

Antimicrobial Agents and Chemotherapy
|March 29, 2005
PubMed
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Drug interactions between procainamide and fluoroquinolones were studied. Levofloxacin and ciprofloxacin significantly altered procainamide and N-acetylprocainamide (NAPA) pharmacokinetics, particularly renal clearance.

Area of Science:

  • Pharmacology
  • Drug Interactions
  • Clinical Pharmacology

Background:

  • Procainamide is an antiarrhythmic drug.
  • Fluoroquinolones like levofloxacin and ciprofloxacin are broad-spectrum antibiotics.
  • Potential drug interactions between these classes require investigation.

Purpose of the Study:

  • To investigate the pharmacokinetic interaction between procainamide and levofloxacin.
  • To examine the pharmacokinetic interaction between procainamide and ciprofloxacin.

Main Methods:

  • A randomized, crossover study involving ten healthy adults.
  • Administration of procainamide alone, with levofloxacin, and with ciprofloxacin.
  • Measurement of pharmacokinetic parameters, including renal clearance and renal clearance/creatinine clearance ratios.

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Main Results:

  • Levofloxacin significantly altered most procainamide and N-acetylprocainamide (NAPA) pharmacokinetic parameters (P < 0.05).
  • Ciprofloxacin significantly decreased procainamide and NAPA renal clearances.
  • Renal clearance and renal clearance/creatinine clearance ratios were affected by levofloxacin.

Conclusions:

  • Concomitant use of procainamide with levofloxacin or ciprofloxacin can alter procainamide pharmacokinetics.
  • These interactions primarily involve changes in renal clearance.
  • Caution is advised when co-administering procainamide with fluoroquinolones.